Visual Side Effects Linked to Sildenafil Consumption: An Update

Phosphodiesterase type 5 (PDE5) inhibitors such as Viagra® (sildenafil citrate) have demonstrated efficacy in the treatment of erectile dysfunction (ED) by inducing cyclic guanosine monophosphate (cGMP) elevation followed by vasodilation and increased blood flow. It also exerts minor inhibitory action against PDE6, which is present exclusively in rod and cone photoreceptors. The effects of sildenafil on the visual system have been investigated in a wide variety of clinical and preclinical studies due to the fact that a high dose of sildenafil may cause mild and transient visual symptoms in some patients. A literature review was performed using PubMed, Cochrane Library and Clinical Trials databases from 1990 up to 2020, focusing on the pathophysiology of visual disorders induced by sildenafil. The aim of this review was not only to gather and summarize the information available on sildenafil clinical trials (CTs), but also to spot subpopulations with increased risk of developing undesirable visual side effects. This PDE inhibitor has been associated with transient and reversible ocular side effects, including changes in color vision and light perception, blurred vision, photophobia, conjunctival hyperemia and keratitis, and alterations in the electroretinogram (ERG). Sildenafil may induce a reversible increase in intraocular pressure (IOP) and a few case reports suggest it is involved in the development of nonarteritic ischemic optic neuropathy (NAION). Reversible idiopathic serous macular detachment, central serous retinopathy and ERG disturbances have been related to the significant impact of sildenafil on retinal perfusion. So far, sildenafil does not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors as long as the therapeutic dose is not exceeded and is taken under a physician’s direction to treat a medical condition. However, the recreational use of sildenafil can lead to harmful side effects, including vision changes

Biomarkers for Alzheimer’s Disease Early Diagnosis

Alzheimer’s disease (AD) is the most common cause of dementia, affecting the central nervous system (CNS) through the accumulation of intraneuronal neurofibrillary tau tangles (NFTs) and β-amyloid plaques. By the time AD is clinically diagnosed, neuronal loss has already occurred in many brain and retinal regions. Therefore, the availability of early and reliable diagnosis markers of the disease would allow its detection and taking preventive measures to avoid neuronal loss. Current diagnostic tools in the brain, such as magnetic resonance imaging (MRI), positron emission tomography (PET) imaging, and cerebrospinal fluid (CSF) biomarkers (Aβ and tau) detection are invasive and expensive. Brain-secreted extracellular vesicles (BEVs) isolated from peripheral blood have emerged as novel strategies in the study of AD, with enormous potential as a diagnostic evaluation of therapeutics and treatment tools. In addition; similar mechanisms of neurodegeneration have been demonstrated in the brain and the eyes of AD patients. Since the eyes are more accessible than the brain, several eye tests that detect cellular and vascular changes in the retina have also been proposed as potential screening biomarkers. The aim of this study is to summarize and discuss several potential markers in the brain, eye, blood, and other accessible biofluids like saliva and urine, and correlate them with earlier diagnosis and prognosis to identify individuals with mild symptoms prior to dementia

Gamificación y neurodidáctica en la atención a la diversidad funcional en la escuela rural.

Este trabajo es la ventana a una nueva educación, a la educación para los que están llamando con fuerza que quieren algo más y algo mejor, ellos son la diversidad funcional de nuestras aulas y que gracias a Coral Elizondo se conoce más esa inclusión y la difusión de trabajar con el diseño universal de aprendizaje, a pesar de que hoy siga siendo una utopía. Gracias a las investigaciones del cerebro, los docentes ya podemos hablar de tú a tú con psicólogos clínicos y neurólogos. La aplicación de la neurociencia en las aulas es un hecho, sin miedo, aunque con mucho trabajo y si además entra la motivación con la gamificación, aleluya, porque circulan muchos neuromitos, gamamitos, neuromodas, etc. que lo único que hacen es entorpecer el camino que conduce al éxito. En este trabajo conoceremos a un personaje singular que nos guiará por la mejor docencia con corazón y cerebro como dice Martín Pinos.<br /

Relationship of Limb Lengths and Body Composition to Lifting in Weightlifting

Weightlifting is a discipline where technique and anthropometric characteristics are essential to achieve the best results in competitions. This study aims to analyse the relationships between body composition, limb length and barbell kinematics in the performance of weightlifters. It consists of an observational and descriptive study of 19 athletes (12 men [28.50 ± 6.37 years old; 84.58 ± 14.11 kg; 176.18 ± 6.85 cm] and 7 women [27.71 ± 6.34 years old; 64.41 ± 7.63 kg; 166.94 ± 4.11 cm]) who met the inclusion criteria. A level I anthropometrist took anthropometric measures according to the methodology of the International Society for the Advancement of Kinanthropometry (ISAK), and the measurement of the barbell velocity was made with the software Kinovea. In terms of body composition, both genders are within the percentage range of fat mass recommended for this sport. In female weightlifters, there is a positive correlation between foot length, maximal velocity in the Snatch (ρ = 0.775, p = 0.041), and performance indicator in the Snatch and the Clean & Jerk (ρ = 0.964, p < 0.001; ρ = 0.883, p = 0.008, respectively). In male weightlifters, a positive correlation between tibial length and average velocity of the barbell in the Snatch is observed (ρ = 0.848, p < 0.001). Muscle mass percentage correlates positively with performance indicator in both techniques (ρ = 0.634, p = 0.027; ρ = 0.720, p = 0.008). Also, the relative length of the upper limb is negatively correlated with the performance indicator (ρ = −0.602, p = 0.038). Anthropometry and body composition may facilitate skill acquisition among this sport population, contributing to increase the limited body of scientific knowledge related to weightlifting

Intranasal delivery of Thyroid hormones in MCT8 deficiency

Loss of function mutations in the gene encoding the thyroid hormone transporter monocarboxylate transporter 8 (MCT8) lead to severe neurodevelopmental defects in humans associated with a specific thyroid hormone phenotype manifesting high serum 3,5,3’-triiodothyronine (T3) and low thyroxine (T4) levels. Patients present a paradoxical state of peripheral hyperthyroidism and brain hypothyroidism, this last one most likely arising from impaired thyroid hormone transport across the brain barriers. The administration of thyroid hormones by delivery pathways that bypass the brain barriers, such as the intranasal delivery route, offers the possibility to improve the neurological defects of MCT8-deficient patients. In this study, the thyroid hormones T4 and T3 were administrated intranasally in different mouse models of MCT8 deficiency. We have found that, under the present formulation, intranasal administration of thyroid hormones does not increase the content of thyroid hormones in the brain and further raises the peripheral thyroid hormone levels. Our data suggests intranasal delivery of thyroid hormones is not a suitable therapeutic strategy for MCT8 deficiency, although alternative formulations could be considered in the future to improve the nose-to-brain transport.This work was supported by the Spanish Ministry of Economy and Competitiveness, grant number SAF2017-86342-R (MINECO/AEI/FEDER, UE) to AG-F, the Sherman Foundation (grant number OTR02211) to AG-F and SB-L, and the BBSRC (grant number BB/R016879/1) to SB-L. CG-M is a recipient of a contract from the Center for Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid. S.R. was supported by grant DK15079 from the National Institutes of Health, USA. The cost of this publication has been paid in part by FEDER funds (European Funds for Regional Development). We acknowledge support of the publication fee by the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI)

La relación de la conducta disruptiva en el rendimiento y la salud mental de niños de primaria modulada por la empatía y el sexo.

El objetivo de este trabajo es analizar la relación de la conducta disruptiva en el rendimiento (lengua y matemáticas) y la salud mental (ansiedad y depresión) de niños de primaria modulada por la empatía y el sexo. La muestra estuvo constituida por 45 niños de 3º de primaria con edades comprendidas entre los 8 y los 9 años pertenecientes a un centro educativo de la provincia de Zaragoza. Los resultados muestran correlaciones negativas entre conducta disruptiva y empatía cognitiva, conducta disruptiva, habilidades sociales y reactividad emocional. Por el contrario, conducta disruptiva presenta una correlación positiva con ansiedad y negativa con el área de lengua castellana. Encontramos una correlación positiva entre empatía, habilidades sociales y reactividad emocional. Empatía, presenta asimismo una relación positiva con las dos áreas del rendimiento. Por el contrario, empatía presenta una correlación negativa con ansiedad. Respecto a habilidades sociales, posee una correlación positiva con reactividad emocional y con las dos áreas de rendimiento y correlaciones negativas con ansiedad y depresión. Reactividad emocional presenta correlaciones positivas significativas con ambas áreas de rendimiento y una relación negativa con ansiedad. Depresión presenta correlaciones significativas negativas tanto con lengua castellana como con matemáticas. Por último, respecto al sexo, ser chico correlaciona positivamente con tener mayores niveles de conducta disruptiva y ansiedad, mientras que ser chica lo hace con los mayores niveles de empatía, de reactividad emocional y de calificaciones en lengua.<br /

Rendimiento académico del ABP en Anatomía

Desde que en la Universidad de Alicante se implantaron los nuevos planes de estudios EEES en el curso 2010-11, hasta la actualidad, se ha estado aplicando la metodología docente colaborativa de aprendizaje basado en problemas (ABP) en asignaturas del área de Anatomía Humana y Embriología impartidas en los primeros cursos de las titulaciones de Grado en “Enfermería”, “Nutrición Humana y Dietética”, “Óptica y Optometría” y “Ciencias de la Actividad Física y del Deporte”. El objetivo de este estudio es comparar los resultados de aprendizaje a través del rendimiento académico obtenido en la evaluación continua según diferentes metodologías docentes. En general, las calificaciones obtenidas en la evaluación de la exposición oral en grupo del trabajo ABP fueron mucho mejores en todas las asignaturas a lo largo de los últimos 5 años. Los resultados de las pruebas objetivas de respuesta múltiple usadas para evaluar los logros de aprendizaje mediante el uso de clases magistrales de teoría y prácticas de laboratorio fueron algo inferiores. Se plantea la posibilidad de incrementar el número de actividades de ABP y asignar un mayor peso en la ponderación de los criterios de evaluación de la asignatura

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

BACKGROUND: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. METHODS/DESIGN: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. RESULTS: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. CONCLUSION: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. TRIAL REGISTRATION: Registered in DRKS register, ID number: DRKS0000479

Integración del inglés en materias de Anatomía

En el curso 2012-13 iniciamos un proyecto de trabajo en red para favorecer la integración del inglés en 5 materias de Ciencias de la Salud. Dado que el aprendizaje de esta segunda lengua es una competencia básica transversal e instrumental en los Grados de la Universidad de Alicante, en el presente estudio pretendemos valorar el nivel de adquisición simultánea en lengua inglesa y española de nuevos términos anatómicos, así como el nivel de conocimientos genéricos de comprensión lectora y escritora del inglés. Para ello, al principio y final del primer semestre del curso 2013-14, se realizaron encuestas con preguntas de respuesta múltiple en las asignaturas de Anatomía impartidas en los primeros cursos de 4 Grados: Enfermería, Nutrición Humana y Dietética, Óptica y Optometría y Ciencias de la Actividad Física y del Deporte. Observamos una cierta mejora en la adquisición de términos anatómicos en inglés según el sistema de aprendizaje integrado de contenidos en lengua extranjera (AICLE). Sin embargo, los conceptos genéricos de la lengua inglesa permanecen constantes o incluso se algo disminuidos. Concluimos que en un entorno AICLE, con materiales curriculares bilingües, se obtienen buenos resultados de aprendizaje en las materias de Anatomía integradas con el inglés

Fatal Events in Cancer Patients Receiving Anticoagulant Therapy for Venous Thromboembolism.

In cancer patients treated for venous thromboembolism (VTE), including deep-vein thrombosis (DVT) and pulmonary embolism (PE), analyzing mortality associated with recurrent VTE or major bleeding is needed to determine the optimal duration of anticoagulation.This was a cohort study using the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) Registry database to compare rates of fatal recurrent PE and fatal bleeding in cancer patients receiving anticoagulation for VTE.As of January 2013, 44,794 patients were enrolled in RIETE, of whom 7911 (18%) had active cancer. During the course of anticoagulant therapy (mean, 181 ± 210 days), 178 cancer patients (4.3%) developed recurrent PE (5.5 per 100 patient-years; 95% CI: 4.8-6.4), 194 (4.7%) had recurrent DVT (6.2 per 100 patient-years; 95% confidence interval [CI]: 5.3-7.1), and 367 (8.9%) bled (11.3 per 100 patient-years; 95% CI: 10.2-12.5). Of 4125 patients initially presenting with PE, 43 (1.0%) died of recurrent PE and 45 (1.1%) of bleeding; of 3786 patients with DVT, 19 (0.5%) died of PE, and 55 (1.3%) of bleeding. During the first 3 months of anticoagulation, there were 59 (1.4%) fatal PE recurrences and 77 (1.9%) fatal bleeds. Beyond the third month, there were 3 fatal PE recurrences and 23 fatal bleeds.In RIETE cancer patients, the rate of fatal recurrent PE or fatal bleeding was much higher within the first 3 months of anticoagulation therapy